Background: Ovarian vein thrombosis has been described postpartum and after pelvic surgery, but is uncommon in first- and second-trimester abortions. Case: A 24-year-old woman, para 1011, presented 9 days after an uneventful elective abortion at 13 weeks' gestation with right lower quadrant abdominal pain, rebound tenderness and a normal white blood cell (WBC) count. Computed tomography (CT) showed ovarian vein thrombosis that improved with anticoagulation and antibiotics. Conclusion: Ovarian vein thrombosis might occur after elective first-trimester abortion and have an atypical presentation. (C) 2000 by The American College of Obstetricians and Gynecologists.